Income Inequality Makes People Sick

Living in a community with a big income disparity between rich and poor is bad for your health.

That's the conclusion of an analysis in The New York Times of a vast new report that rates the healthfulness of every county in the U.S. The report, from the University of Wisconsin Population Health Institute and the Robert Wood Johnson Foundation, ranks every county on a range of health-related factors, from behaviors like smoking and drinking to social issues like crime and unemployment and environmental problems like air pollution.[You can click here to find out how your county and state rank in the 2015 County Health Rankings.]

Living in a poor community has long been accepted as a health risk factor, contributing to a variety of health problems and shortening life spans.

The New York Timesanalysis suggests that income inequality in a community is a risk factor, too. That is, people are less healthy if they live in a community that has a big disparity between the richest and the rest of us. People in unequal communities were more likely to die before age 75 than people in more equal communities, even when the average overall income in the communities was virtually the same.

It's called "the inequality effect," and several possible reasons for it are cited:

• A community with a wide income disparity usually has a few very rich people, and many more poor people. Those numbers tilt the data towards risk factors that affect the poor, like inadequate health care and bad nutrition.

• The very rich may not invest in the communities where they live. They send their children to private schools and travel for the best health care. That leaves the rest of us to support local schools, hospitals and other services that are critical to community health.

• Life might just be more stressful in a community with a wide income inequality.

In any case, poverty had a measurable impact on health. In every state, the poverty rate in the unhealthiest county was more than twice as high as in the healthiest county. The unemployment rate in the unhealthiest counties was 1.5 times higher than in the healthiest ones. The child poverty rate was more than twice as high in the unhealthiest county as in the healthiest.

This year's County Health Rankings has some good news overall about the nation's health. It finds that rates of premature death--that is, death before age 75--have declined in 60 percent of the counties in the U.S., in some cases dramatically. The most improvement was seen in Washington D.C., where the rate of premature death dropped by nearly one-third, in a comparison of data from 2004-2006 and from 2010-2012.

So, what are the characteristics of the "healthiest" county in each state? All have higher college attendance, fewer preventable hospital stays, and better access to parks and gyms. The unhealthiest counties have more smokers, more teen births and more alcohol-related car crashes.